Study presenter Mark Sulkowski at CROI 2011. Photo by Liz Highleyman / aidsmap.com
hepatitis C protease inhibitor telaprevir seems to works well in people
co-infected with HIV and hepatitis C.
The experimental drug was used in combination with established
hepatitis C therapy consisting of pegylated interferon and ribavirin.
Telaprevir is known to work well when combined with these
patients who are only infected with hepatitis C. Researchers wanted to see
how safe and effective the experimental therapy was in co-infected patients.
Their research had two parts. The first included patients
with a high CD4 cell count who were not yet taking antiretroviral therapy.
The second involved people who were taking HIV therapy based
on either efavirenz
(Sustiva or Stocrin) or atazanavir
(Reyataz). These drugs were selected
because laboratory tests showed they had a low risk of interacting
Patients in both parts of the study were randomised to
receive either telaprevir or a placebo.
Overall, after four weeks of treatment 70% of people taking
telaprevir had an undetectable hepatitis C viral load, compared to only 5% of those
taking the placebo.
Results were broken down according to the type of HIV
treatment a patient was taking. Undetectable hepatitis C viral load was seen in
75% of people not taking HIV therapy; in 71% of people taking efavirenz-based
therapy; and in 65% of people taking atazanavir-based treatment.
However, the small numbers of patients in the study meant
that the researchers couldn’t compare outcomes between the drugs.
Blood levels of telaprevir were good, and it had only a
modest impact on concentrations of anti-HIV drugs. Treatment with telaprevir
did not have an adverse impact on either HIV viral load or CD4 cell count.
The researchers said that they’d be comfortable treating
patients who were taking efavirenz or atazanavir with telaprevir.
Clinical trials are continuing.